I just had my first physical since going Paleo about a year ago. I've altered my diet significantly over the past year, mostly by adding fat in the form of things like grass-fed beef, eggs, pastured butter etcetera, and lowering carbohydrates in the form of things like cereals, breads, etcetera. I was expecting an increase in my LDL, but the jump was far more acute than I was prepared for. My total cholesterol went up from about 180 to 270 with very high levels of both HDL and LDL. Thankfully, my doc did not suggest a statin, but he did suggest that action need be taken; his advice was to lower saturated fat and cholesterol in my diet. I have loved being Paleo over the past year. I feel very good. I prefer the food. And my body fat has gone down to under 10% while I've put on lean muscle. But I'm also not prepared to play with fire, and not withstanding a good HDL number, my total cholesterol of 270 does not sit well with me. Anyway, wondering whether you all agree with my concern about the number and wondering what you would do in my position. I've learned too much over the past year to consider going back to a standard American diet, but though I want to believe that saturated fat/cholesterol consumption is harmless, I am going to lower my intake of both, replacing saturated fat rich foods with monounsaturated fat rich foods like avocado and fish. I had been eating about 3 eggs/day for the past year, 75/25 grass-fed ground beef about 3-4 times/week, along with bacon, sausages etcetera. I'm going to reduce my consumption of those items, while continuing to eat a Paleo diet void of grains and reduced in sugars.
What do you all think of this? How would you react to the results? What action (if any) would you take?
asked byGary_4 (250)
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on March 16, 2013
at 06:26 PM
If you were eating butter and cream, discontinue that practice altogether. It's possible that you hyperrespond to dietary cholesterol. This part is tricky since pastured eggs yolks are such an excellent source of nutrition. I would say that if it turned out to be the case that you'd be better off with elevated lipids with the eggs than lower cholesterol without. Odds are, however, that it's simply a result of saturated fat intake.
Personally I would first eliminate dairy fats for 90 days and re-test. If the same, I would eliminate the processed meats you mentioned and wait another 90. Only then would I attempt to remove the egg yolks if there wasn't a difference.
If you're not currently supplementing with magnesium glycinate, start. Magnesium insufficiency results in higher LDL, lower HDL and higher triglycerides.
on March 17, 2013
at 10:06 PM
A total cholesterol of 270 is not that bad. Based on empirical evidence, a total cholesterol between 200 and 260 has corresponded to the lowest rate of mortality. Before considering something like cutting dairy fat, I'd recommend that you ensure that you're micronutrient sufficient, namely, copper, iodine, selenium, vitamin D, and magnesium.
on March 16, 2013
at 08:07 PM
Gary, all of the above advice is excellent. It sounds like all is need is some minor adjustments to your diet, which you obviously realize, and get re-tested in 90 days. Your doctor is making the right call: no need for alarm, just some caution and prudent action.
Your post reminds me to get my cholesterol checked. I have been Paleo for about a year. Last June my cholesterol test results showed very low cholesterol (TC=120) and triglyceride levels.
on March 16, 2013
at 06:30 PM
If trigs are low and HDL is high, I'd be happy with anything up to 240/250. 270 is pushing it, IMHO, but it's not terrible.
What else do you eat? If you're not eating plenty of fresh fruits, veggies, potato/sweet potato, I'd knock back on the meats a bit and add more of those foods. Agree with greymouser that no point in cutting back on dietary cholesterol consumption, but I do think it's quite possible to go overboard on the protein & fat intake.
If you're already exercising regularly, give some thought to how much regular movement you get, that is, are you exercising but then sitting down most of the rest of each day? If so, would start to think about how you could sit less. If you're not already exercising regularly, I'd start.
on March 16, 2013
at 05:42 PM
First, definitely get tested again in a few months. More data will be helpful for you.
Many here will probably say that 270 isn't too bad, considering you claim a very high HDL. I'm leaning towards that myself, but if you really would feel more comfortable with a lower score, I would say aim for 200-240 -- frankly, not a big drop. 270 does put you in as much risk for all cause mortality as 180 does - 200-240 would be optimal there. However, 270 would hypothetically put you at more risk specifically for cardiovascular disease -- but again, 200-240 seems to be the magic zone. This range is often quoted as it's from an analyses on the WHO data - more info here - http://perfecthealthdiet.com/2011/06/blood-lipids-and-infectious-disease-part-i/ -- not sure if the original is down now, or not.
On the ground, I would suggest lowering saturated fat but specifically not eating a "low saturated fat" diet. Saturated fat does tend to increase overall cholesterol. Just don't swing 100% the opposite way and eat "low fat". I personally do not believe that high in dietary cholesterol foods (eggs, shrimp, etc) are going to effect your serum levels as much.
Your suggestions are pretty good. More avocados and fish? Go for it! Sausage can be very iffy, so I would make that a sometimes food. Bacon, too -- hey, it's delicious, but you don't really need it everyday, do you? ;-) Generally I would suggest making pork and chicken & duck a once a week or so food, and primarily eat ruminants (beef, lamb, goat) and fish (so many to choose from!). Veggie wise, I would suggest adding plenty of tubers and roots (cassava, sweet potatoes, true yams, squashes, potatoes, taro, etc), and assuming you've otherwise had a variety of green and colorful veggies in your diet, to stick with that. Don't miss a chance to dress veggies in olive oil -- SFAs and MUFAs are both very benign. It's hard to give up eggs everyday, as they are so easy to prepare, delicious, and filling. I'm not too suspect of them, but if you must, maybe just eat dinner leftovers the next morning. :-)
Good luck - and let us know if you change your results.